COASTAL COMMUNITY RETIREMENT CORPORATION (NPI# 1295745453) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295745453 |
| Entity Type | Organization |
| Organization Name | COASTAL COMMUNITY RETIREMENT CORPORATION |
| Other Organization Name | MARSH'S EDGE |
| Practice Address |
136 Marshsedge Lane St. Simons Island GA 31522 |
| Practice Telephone | 9122912001 |
| Mailing Telephone | 9122912001 |
| Mailing Fax Number | 9122912098 |
| Enumeration Date | 2006-08-09 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | ROBERT B REES (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 9122912004 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2000X |
Clinic/Center Specialization: Physical Therapy |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Marsh's Edge | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588674261 | Coastal Community Retirement Corporation | Skilled Nursing Facility | 111 Renegar Way, St. Simons Island, GA 31522 | 2006-08-08 |
| Street Address |
136 MARSHSEDGE LANE |
| City | ST. SIMONS ISLAND |
| State | GA |
| Zip Code | 31522 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982186342 | Matthew Mackinnon Gibbs | Specialist/Technologist | 211 Village Dr, St Simons Is, GA 31522 | 2018-09-02 |
| 1770957433 | Jennifer Herrin, Lpc | Community/Behavioral Health | 400 Main Street, Cottage 1, Saint Simons Island, GA 31522 | 2015-11-18 |
| 1508113002 | Ashley Neal Callicutt | Counselor | 301 Sea Island Road, Suite G, St. Simons Island, GA 31522 | 2012-08-14 |
| 1235414103 | Dana D'andrea Duggan | Psychologist | 283 Redfern Village, St. Simons Island, GA 31522 | 2011-10-11 |
| 1528394848 | Nancy Hodges Bowen | Nurse Practitioner | 7000 Wellness Way, Suite 130, St. Simons Island, GA 31522 | 2009-10-21 |
| 1073763215 | John Arthur Hendry | Dentist | 511 Mallery Street, St. Simons Island, GA 31522 | 2008-09-24 |
| 1770775116 | Randolph M. Stevens | Dentist | Coastal Endodontic Associates, 1804 Frederica Rd., Ste B, St. Simons Island, GA 31522 | 2007-08-09 |
| 1689797383 | Angela C Barnard | Nurse Practitioner | 798 Mallery St Apt 2, Saint Simons Island, GA 31522 | 2007-04-09 |
| 1053493486 | Larry D. Daugherty | Dentist | 124 Island Professional Park, St Simons Island, GA 31522 | 2006-10-19 |
| 1134239460 | Joe Neil Garner | Dentist | 288 Redfern Village, St Simons Island, GA 31522 | 2006-08-30 |
| Find all providers in zip 31522 | ||||
| Taxonomy Code | 261QP2000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Physical Therapy |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982205159 | Thrive Therapy and Wellness Services LLC | Clinic/Center | 106 Mims Rd, Sylvania, GA 30467-1995 | 2020-11-04 |
| 1851990063 | On The Move Massage & Physical Therapy | Clinic/Center | 7454 Silver Arrow Trl, Austell, GA 30168-2401 | 2020-10-19 |
| 1659979086 | Mvp Physio Dr. | Clinic/Center | 123 Umiya Nagar Cir, Macon, GA 31206-5401 | 2020-10-16 |
| 1972100865 | Resilient Physio, LLC | Clinic/Center | 790 West Ave, Cartersville, GA 30120-3402 | 2020-10-05 |
| 1205441987 | Fortitude Movement & Strength Inc. | Clinic/Center | 5300 Peachtree Rd Unit 2508, Atlanta, GA 30341-2457 | 2020-09-10 |
| 1376151001 | Mother and Baby Wellness Collective, LLC | Clinic/Center | 136 Millstone Way, Canton, GA 30115-7270 | 2020-07-20 |
| 1225646821 | Innovative Therapeutic Solutions, LLC | Clinic/Center | 360 Pharr Rd Ne Apt 404, Atlanta, GA 30305-2391 | 2020-07-20 |
| 1669090544 | Active Body Physiotherapy | Clinic/Center | 2968 Ask Kay Dr Se Ste B, Smyrna, GA 30082-2304 | 2020-07-08 |
| 1487270914 | Docjay Physical Therapy | Clinic/Center | 6740 Shannon Pkwy Ste 14, Union City, GA 30291-2061 | 2020-06-20 |
| 1477176923 | R & J Health Care | Clinic/Center | 6853b Douglas Blvd Ste B, Douglasville, GA 30135 | 2020-05-19 |
| Find all providers with the same taxonomy | ||||
| City | ST. SIMONS ISLAND |
| Zip Code | 31522 |
Please comment or provide details below to improve the information on COASTAL COMMUNITY RETIREMENT CORPORATION.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.